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Background: Little is known about motor vehicle collision (MVC) risk in older drivers with age-related macular degeneration (AMD). The purpose of this study is to examine associations between MVC involvement and AMD presence and severity., Methods: In a retrospective cohort study pooling the samples from four previous studies, we examined associations between MVC rate and older drivers with early, intermediate or advanced AMD as compared with those in normal eye health. MVC data were based on accident reports obtained from the state agency that compiles this information., Results: MVC rate was highest among those in normal eye health and progressively declined among those with early and intermediate disease, and then increased for those with advanced AMD. However, only for drivers with intermediate AMD was the MVC rate significantly different (lower) as compared with those in normal eye health, regardless of whether the rate was defined in terms of person-years (RR 0.34, 95% CI 0.13 to 0.89) or person-miles (RR 0.35, 95% CI 0.13 to 0.91) of driving., Conclusions: These results suggest that older drivers with intermediate AMD have a reduced risk of collision involvement. Further research should investigate whether self-regulatory driving practices by these drivers (avoiding challenging driving situations) underlies this reduced risk.

Aim: To examine associations between retinal thickness and rod-mediated dark adaptation in older adults with non-exudative age-related maculopathy (ARM) or normal macular health., Methods: A cross-sectional study was conducted with 74 adults ≥ 50 years old from the comprehensive ophthalmology and retina services of an academic eye centre. ARM presence and disease severity in the enrolment eye was defined by the masked grading of stereofundus photos using the Clinical Age-Related Maculopathy grading system. High-definition, spectral-domain optical coherence tomography was used to estimate retinal thickness in a grid of regions in the macula. Rod-mediated dark adaptation, recovery of light sensitivity after a photo-bleach, was measured over a 20-min period for a 500 nm target presented at 5° on the inferior vertical meridian. Main outcomes of interest were retinal thickness in the macula (μm) and parameters of rod-mediated dark adaptation (second slope, third slope, average sensitivity, final sensitivity)., Results: In non-exudative disease retinal thickness was decreased in greater disease severity; thinner retina was associated with reductions in average and final rod-mediated sensitivity even after adjustment for age and visual acuity., Conclusions: Impairment in rod-mediated dark adaptation in non-exudative ARM is associated with macular thinning.

Background: Two recent studies reported over 70% of the patients with non-arteritic anterior ischaemic optic neuropathy (NAION) had sleep apnoea syndrome (SAS) diagnosed by overnight polysomnography. The current study used the Sleep Apnea scale of the Sleep Disorders Questionnaire (SA-SDQ) to evaluate this association., Methods: A matched case-control study was conducted among 73 cases of NAION matched on age and gender to 73 controls without a history of NAION. Information regarding demographics, medical conditions, health behaviours and SAS was obtained via a telephone questionnaire that included the SA-SDQ. Conditional logistic regression was used to calculate odds ratios (OR) and the 95% confidence intervals (CI) for the association between NAION and the SA-SDQ., Results: Cases were significantly more likely to report symptoms and characteristics consistent with SAS than controls (OR 2.62; 95% CI 1.03 to 6.60) when adjusted for medical and health behaviour characteristics., Conclusions: The results of this study suggest that patients with SAS are at increased risk of NAION. Additional research in a larger population is needed to confirm the observed results and validate the use of the SA-SDQ in patients with NAION.

Aim: To assess the impact of cataract surgery in nursing home residents on health-related quality of life, as compared to those who have cataracts but who do not undergo surgery., Methods: A prospective cohort study enrolled 30 nursing home residents (>or=60 years old) who had cataracts and underwent cataract surgery, and evaluated vision-targeted and generic health-related quality of life and depressive symptoms before and approximately 4 months after surgery. This cataract surgery group was compared to 15 nursing home residents who had cataracts but who did not have surgery, over the same timeframe., Results: Visual acuity for near and distance and contrast sensitivity improved following cataract surgery (p<0.001). Adjusting for age differences in the two groups, the cataract surgery group exhibited significant score improvement in the general vision (p = 0.005), reading (p = 0.001), psychological distress (p = 0.015), and social interaction (p = 0.033) subscales of the Nursing Home Vision-targeted Health-Related Quality of Life Questionnaire and the VF-14 (p = 0.004). There were no group differences in the SF-36, Geriatric Depression Scale or the Cataract Symptom Score., Conclusion: Nursing home residents who underwent cataract surgery because of functional problems experienced significant improvements in their vision-targeted health-related quality of life, in addition to dramatically improved vision.

Aims: To evaluate the association between age related maculopathy (ARM) and statin use., Methods: A nested case-control study among patients at the Veterans Affairs Medical Center in Birmingham, Alabama, with newly diagnosed ARM (cases) between 1997 to 2001 were selected and age matched to non-ARM controls., Results: 550 incident cases of ARM were identified and matched to 5500 controls. Overall, cases were 70% (OR 0.30, 95% CI 0.21 to 0.45) less likely to have received and filled a statin prescription relative to the controls. This association was present among both current and past (OR 0.34, 95% CI 0.21 to 0.53 and OR 0.26, 95% CI 0.14 to 0.47, respectively) statin users. When considering use of statin and/or non-statin lipid lowering medications, a significant risk reduction was observed for statin only users (OR 0.30, 95% CI 0.20 to 0.45) and combined statin and non-statin users (OR 0.20, 95% CI 0.06 to 0.64); there was no significant association for non-statin only users (OR 0.47, 95% CI 0.20 to 1.13)., Conclusions: The results of this study suggest that subjects with ARM were significantly less likely to have filled a statin prescription. Future clinical research initiatives should include a clinical trial to provide direct evidence of the effectiveness of statins in lowering the incidence and progression of ARM.